The conventional way that doctors stage COPD is according to the results of the person's pulmonary function tests (also called lung function tests). These are special tests that provide measurements of how much air a person's lungs can hold (the "forced vital capacity," or FVC) and how quickly they can breathe out (the "forced expiratory volume in one second," or FEV1). Doctors compare a person's FVC and FEV1 to predicted numbers that reflect normal lung function in people of the same age, height, and gender. By seeing how much worse lung function is compared to the normal predicted numbers, one can determine the stage of COPD.

This is how COPD is usually staged:

Stage I: Mild COPD

FEV1 is at least 80 percent of normal. In this stage, people may or may not notice any symptoms.

Stage II: Moderate COPD

FEV1 is between 50 and 80 percent of normal. In this stage, people usually experience some shortness of breath with exertion; they may or may not have chronic cough.

Stage III: Severe COPD

FEV1 is between 30 and 50 percent of normal. In this stage, people usually are often tired and short of breath. They may have frequent exacerbation flares (or "flare-ups") requiring extra treatment or even hospitalization.

Stage IV: Very Severe COPD

FEV1 is less than 30 percent of normal; or FEV1 is less than 50 percent of normal and chronic respiratory failure is present (meaning the person needs chronic oxygen therapy). In this stage, people are often short of breath even at rest.

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Thank you for mentioning "exacerbation flares". To the person here asking what to expect, I would advise to be as active as possible. It's easy to become an invalid with this disease. Prevent that from happening. Use inhalers, eat well, rest, but do all you can to remain active.

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I have been told all this yr that husband is in last stages but seems to be about same for last yr, slightly worse as in taking more Neb. Treatments for congestion & can't walk very far without Oxy. level dropping alot, losts of lung infections & prednisone which messes with blood levels in him(takes warfarin for heart arrythmia) causes it to go to thinor thick? & also messes with sugar levels!Needs constant watching & lab checks. Gueass a want a ballpark figure on how they figure out how much (time frame) we are talking here?Can't go or do anything anymore sleeps alot? all he can do mostly is play cribbage or watch TV? they don't even do a lung function test anymore? Guess I'm scared to know but somehow I have to learn how to cope with some sort of acceptance? Noone to talk to, best friend died last year with this? was supposed to come over to visit mein 5 days & that day he fund her expired in bed in her sleep! New she was bad but thought I'd see here lots worse before this happened! I was dumbfounded! Thought I'd have a little more time left with her, came to fast for me! 1 yr. & still hurts me lots although I always wrote to her every night on comp. & told her I loved her without fail so I was pretty much calm when I had to view the casket, I new she was finally at peace!Our anniv. is Jan18 (46 yrs)& he took care of me all this while & I know it's my turn now but hurts bad & always wondering how long I've left with him. This is very trying for me & depressing, no way out must deal with it! Have nervous conditions & donn't go out at all so am here all thime, don't tell me to get out, wouldn't do it anyway, also has slight memory loss so haave tobe here for meds etc. Guess I just need to vent but so appreciate any answeers or your take on this matter, thanks,

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Hello to the caregiving wife,
I understand both sides of this disease as I was caregiver, and now in advanced stage myself. Depression is part of it, and understandable, for both you and your husband. Just being company, sitting with him and talking may help you both. If someone would only fix me a cup of tea, sit and visit would mean so much to me. People demand too much at times, of me. They want to "fix this" and can't make them understand if they would only sit w/me, watch tv even. Share a cup of coffee or tea. It means so much. And works both ways. With my mom she was depressed and anxious at the same time. Her last Thanksgiving, too many demands. I told her, "you don't have to--we can have our own thanksgiving tomorrow or Sat." The relief helped. Our best days were the quiet ones sitting and talking. When I said to try to stay active, I only meant to try to get out, even a little. A ride, or even a drive-thru meal, ride to a park or a nice place to eat and see something other than the four walls at home. Use nebs and inhalers as often as allowed. What about radio? I've become hooked on listening to both music and talk radio. TV is hard on the eyes (and the ears). Try radio. Also can lie in bed w/headphones, adjust volume to low--it helps me, and fewer annoying commercials.

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I am a care giver for a 74 year old who has copd ,and he is at his last stage , it looks like it any way, how can you tell he is at the last stage ? his family is near, but don't never come to see him are even call him , i have been with him for over nine years , and there might have come over maybe twice, if that , what i want to know is how can i help him , without being depression about his kids, he says he don't have no one but me and him , and how dog 'max's, but he is so sad all the time , i try to help cheer him up , but he can't hardly breath to go to the bathroom any more, and the docter's say he an't breath in any air any more , i would love to hear from you , you can e-mail me at ,lewis_brenda@att.net

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my mum who is 61 years old but 30 years old in her mind, has just been diagnosed with severve copd, she was admitted into hospital in oct 09 with an exberation of copd,which thankfully she came out of hospital much herself a little tired. she was hospitalized less than two months later and i must say alot lot worse, her sats dropped to 47 and me (her daughter) my brother and sister were called as things turned for the worse. thankfully after 14days and the shere determination of my mums will to live shes home, she s connected to oxygen 24hours a day, very tired,cant do things for herself. but shes alive!! this is a horrible condition for any human being to have to go thru,x

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Just brought my husband home on Hospice care with maybe just a few weeks left they say! Morphine & Lorazepam & other Drs. say this is no good for lungs but they're doing it anyway & he does get depressed & won't talk to me, the meds do help! Was afraid to give to him at 1st. but when he gets over upset I do give him a min. dose & he mellos out & then will let me put Oxy mask back on him to expell the poison gas exchange going on that's killing him! I'm so tired of 911 calls so now hospice has there numbers on my phones - have to get it through my head it won't get better & can only try to make him comfortable, really hard time accepting this kind of care for him, it's all happening so fast hard to take it all in! I just keep praying that he goes in his sleep, people are starting to call to visit - now you find out who the true friends are not just aquiantences !May God watch over all of us out there who are all going through this at the same time ! & God Speed To Our Significant Others !

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In my case, I have my 89 y.o. mom with COPD living with me. She's only in stage 2 so she mostly takes care of herself. I know I'm lucky at this point. Unfortunately, she also has very high anxiety and that's going to make things really difficult. Meaning, one person mentioned a hospice patient being on lorezapem which my mom is on just for anxiety management not because she's in hospice. Since a lot of you out there have gone through this, what advise do you have for what to expect and how to mentally deal with it. Is there a typical time frame that the inhalers and albuterol stop helping the person breath or does it depend on each person's chemistry?

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Anything I can read about COPD is helpful. I have COPD somewhere between mild and moderate. I recently moved from the condo in which I had lived for 12 years and moved in with my daughter because of my condition. I could not climb stair so a chair lift was installed. But a funny thing happened. After moving I found my condition dramatically improved, so much so that I could climb stairs. When I visited my lung doctor he was flabbegasted to find my lung function had improved 55%. Could there have been something in the condo (mold etc) that was exacerbating my condition and now that it is no longer present I am really back to mild.

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I watched my mother suffer with copd.......I watched her go from useing inhalers to oxygen ...she was on oxygen off and on and in no time seemed like all the time she hardly ever went out ......I remember her last days she went into the hospital she was in there about a week dr said that there was nothing more he could do for her which was very heart breaking she could not even walk to the bathroom which was a foot away with struggleing to breath with the oxgyen.....she came home after a week I remember that she was home maybe 3 days i had talked to her on the phone she said she was going to lay down i said i call her later on than but later never came she passed before i got the chance to talk to her again ......

I watched her suffer threw all stages of this monster ....I also watched my aunt go through it but she went faster than my mom ......I am not trying to scare anyone with copd this is just what i saw mom go through and it is a slow suffering death ......and my heart goes out to all who has it and those around them that have to watch them go through it my mom was only 68 yrs old to young to go.........it been 6 yrs now ....and it seems like only yesterday......

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To reply to BrendaQ, I am not a medical professional however am a daughter of a person with COPD. It sounds like your patient is definitely in stage four and should receive hospice care. I would also do whatever it takes to get his family there. Invite them, tell them he's asking for them, anything. Also, if they're not involved in his life, they shouldn't be in his will. They should be ashamed of themselves.

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My daughter has been an angel. I had to call her after I drove myself to the hospital and was in Emergency hooked up to a number of machines. This young woman has two children to care for and a demanding career and husband. I have a son too but he and his wife are pretty useless. I just experienced my first exacerbating COPD episode which landed me in the hospital. I didn't know these episodes are usually accompanied by pneumonia or pleurisy. I had pneumonia which struck without warning and with the worst pain I have ever felt. I was diagnosed a year ago and am on a C-Pap machine at night, daily Spiriva, and albuterol as needed. I have had no education from my pulmonary doctor about this disease except for "stop smoking". Well dah. I had no idea there were "stages". I also have fibromyalgia which saps my strength and whose drug treatment leaves me dizzy, dopey, drowsy. It breaks my heart to think that she will probably check in on me until the end.

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Living with COPD is miserable. I am in the moderate stage and find it very difficult to do most physical things with out being short of breath. Temporary inhalers only work for a few minutes so I am careful to not use it more that I should. I agree with the anonymous answer. Depression is one of the things that comes with this disease. No one seems to understand. You get lonely and I have periods of times where I don't care about doing the things I like doing. I love to crochet and some times my mom will see me not doing it and she talks to me and it helps. I ache all over all the time. I have been to 4 doctors now and all 4 of them say I have an anxiety disorder. (What?) I need help here not a shove out the door or dismissed as having something I don't have. I have been getting pneumonia a lot since September 2009 and they can not figure out why I keep getting it. Instead of checking my blood for my antibody levels I discovered through my Pulmonologist the emergency room (from my last pneumonia hospitalization 3 weeks ago) checked for arsnik. (What?) (sorry I don't spell so good) Of course it was negative but still. I don't want to harm my self, if I did why on earth would I be to 4 different Doctors and allow my self to be hospitalized for pneumonia several times? My faith in the medical profession in my area is going down a lot. I'm thinking about going to a bigger city.
To help your mom, just try to visit her as much as you can. Call her often and send her cards to lift her spirits. It helps so very much. Ask her about her Doctor visits and make sure she is getting the right kind of care. I hope this helps you and I said a prayer for you and your mom. COPD does not only affect those who have it but their families as well. I'm only 42 years old and my heart breaks for my 2 teen agers who have to watch me be sick and depressed a lot but I thank God for them to cause they shower me with lots of hugs and spend time with me.

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As my profile bio explains, my mother is 80+ and in the last stage of COPD. She has hidden smoking for years, even though it may only be a puff or two or an entire cigarette....while hiding in the bathroom of her condo in Florida. She is on O2 100% and has been recently hospitalized with her entering Stage 4.

There is no energy and a lot of self-pity. She is angry that the hospital aids are not at her beck and call and it takes her so long to just brush her teeth. I guess she has been in denial of her health degeneration since she has lived with asthma all her life.

I live several 1000 miles away and visiting her in the hospital is not an option. I call her but she can't speak because she is out of breath. I don't want to watch a woman die in her own bed caused by her own addictions. I am fully aware there are stages of grief and this one perhaps is anger. Acceptance is the last stage. And I believe that will get there. This disease is slow, like alcoholism is. It slowly pulls the addict down. COPD is a result of my mother's life choices. I see the results and it is very sad.

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To Pegzateach: Please don't blame your mother now; she is suffering enough ! My husband has last stage COPD and only stopped smoking about 5 years ago. He is a VA patient (and they have been so great with his care), but they held back putting him on oxygen until he finally stopped smoking. He is on it full-time now and has gotten much worse of late. He suffers from depression, as most of them seem to. He takes Lorazepam, but it doesn't seem to help much. It keeps me very busy with all his meds; he is on five kinds of breathing meds. including the nebulizer. He also has lost heart muscle from a severe heart attack 16 years ago; had quadruple bypass then.
We live in a rather remote area, too far for me to participate in any group therapy, but I need some kind of info or sharing contact with others who understand. Our two daughters live 250 miles away; they are good to come when necessary, but both work and have their own lives and families. We caregivers for this kind of patient have to suffer along with them and it's so hard not to be able to help him BREATHE!

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I am a sufferer of copd. My children are in a cloud on this probubly denial. For all of you care givers thank you and I wish you were my family. Dont make this your suffering. Only be there as you are for the person suffering. That is the comfort we need. It isnt comforting for the patient to think or beleve that their cargiver is so consumed i sadness. To the one who is so not sympathetic towards her Mom because she smoked which led to this. No one is perfect. Enjoy the time you have , forgive and take care of the ones you love.

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What is the point of asking a question if qualified people do not answer it? I wanted to know if the stages are determined with or without medication and asked the doctor to reply. She didn't. Does she even check the comments? If the answer is no, then this is not a helpful forum.

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The doctor cannot answer questions or concerns without knowing each patient's specific condition. Too many other health factors effect each person. This is a support group to connect with patients and caregivers to vent, share ideas and solutions. If you want specific answers you have to see your personal doctor for an evaluation.

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My mother has COPD and fell and broke her pelvis. She has been unable to rehab from the break because she gets too out of breath even to stand. I tried to bring her home over thanksgiving and could not care for her. I have had to put her in a nursing home, where she is deteriorating rapidly. I have had to close down her apartment and get rid of all the "junk" of life... It is sooooo sad. She was such a independent and successful professional woman. Now she is only a shell of a person, and my heart has broken. My aunt also died of lung cancer last may, that was her sister. SO needless to say I stopped smoking in March of last year. My mom did not stop smoking until the day she fell, now she is physically incapable of smoking and is bedridden. I am unbelievably sad and horribly guilty that I am not able to care for her at home, but I just couldn't do it. I work full time and have no training in caring for someone like that. It is terribly sad shutting down her apartment and i have to stop to cry every hour or so. A lifetime of hard work, and everything is just going to the dumpster basically. I don't have room to store things and they aren't worth enough to warrant getting a storage unit. I almost hope she does not last long, I just can't imagine her being like this for ten years or something.

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I have been married 42 years to this man. I just had to put him in a nursing home with stage 4 COPD. He is hospice. He is also a paraplegic caused by a spinal cord stroke in 2006. He has a peg tube because he can not eat. He has had lots of other health problems through the years including infections,and several bouts of pneumonia. He has less the 20 % lung capacity.
To make a long story short there was no way I could do all that was needed for him. He has anxiety attacks often and has to have medicine to calm him. I am having trouble coping with it all. I also have a few medical problems cropping up now. I am 65 and husband is 63. In my heart I know I did the right thing, but cry a lot when reality hits. Anyone out there have words of wisdom? I am not sure how much of his SS check they will take and I am scared for us both!

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My FIL has been in end stage COPD for over a year and he is one angry man, my husband and i are his caregivers, we also take care of MIL who has congestive heart failure and had a series of strokes 10 years back.anyhow my FIL is very hard to deal with most days as he is so crabby we are trying to help him and all we get is yelled at:( he also has complete renal failure and my husband drives him three days a week to dyalisis. were all getting tired, just pooped mentally and pyhiscally.just this morning he had to go in for surgery due to his fistula being blocked again. he is in the hosptial like a revolving door. sometimes i dont know how were going to get through it,but i suppose we will someway. this is an awful disease and an awful way to die.

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to suzyq5558 -- I understand how hard it is and how this takes a toll on your health. I took care of first my Dad, then my Mom, by myself while my sister and brother did nothing. It took over my life, drained my finances and was a painful ordeal. But I will tell you that now, years later, that I would do it the same again. You're doing the right thing.

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I am my mother's caretaker and have been for several years now.
She is currently in the hospital recovering from respitory failure, asthma, and pnemonia. This is the first of the respitory failures to come according to her home health nurse. (She is such a dear sweet woman who does care. She advisies me on what's to come. Even tho she doesn't always want to tell me.)
Momma has been in the end stages for several years now. But now She is not going to bounce back. She is going to have to wear o2 24/7 now. The neb will increase as well as other meds.
Only God can tell me how long we have together.
This is the hardest thing that I have ever done in my life.
God how I wish I could take it all away from her.
I can make my head understand what is happening but, my heart.....Please Dear God don't allow them to suffer

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COPD is different for every patient. Some people with COPD have not smoke a day in thier life. Those seem to progress slower.
I can tell you that dust, indoor animals, cobwebs, mold, mildew,and stuff like that are major triggers. The cleaner the home is kept the easier it is to breath.
There is no way of knowing a time frame because no two people are exactly alike. My momma has gone two years past the five years she was givin. Now she is getting really bad. I am hoping and praying that we have at least a year or two. there is so much she wants to do.

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I want to say how deeply sorry I am for the patients and caregivers dealing with COPD. I lost my beloved 91 year old mother to COPD on April 17, 2011. She smoked for over 50 years and had stopped smoking 20 years ago; however, the damage was already in her lungs.Seven years ago she began to use oxygen nightly and five years ago oxygen 24 hours daily.She always seemed to breathless with any exertion. She became increasing short of breath throughout the month of March ; began to sleep constantly and was hospitalized twice. She resided in her home with my Dad and my second oldest brother lived with them as primary caregiver. When we realized after three days in ICU that her prognosis was not hopeful we had EMS transport her back home . She died quietly in bed after being home appx. one hour. My sister and I visited every day and do still see our dad and brother daily. We miss Mama more than anyone can imagine. She had always been so lively and intersted in everything. She was our Mother and best friend. This will be a very difficult Mothers Day as we always enjoyed pampering her. It would be a true blessing if people realized how deadly smoking is to their health.

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my husband FEV1 IS 28%.AND THE FEV1/FVC RATIO IS 43%,THEY SAY THAT THERE IS A 56%IMPROVEMENT ON HIS FEV1 AND A43% IMPROVEMENT IN HIS FORSED VITAL CAPACITY, AND HIS LUNG DIFFUSING CAPACITY FOR CARBON MONOXIDE IS SEVERELY DETERIORATED. THERE IMPRESSION IS SEVERE OBSTructive airway disease and 2 severely deteriorated diffusing capacity. what this mean and how long can someone live with this he still smoke cig but they told me that they didnt count cig .thank you

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I would like to write about myself and hope that will give the ones who have given up to get up and move. One step at a time is what it will take.
My mother was diagnosed with E but an anerism took her from us. Myself at that time, she checked my o2 by the finger oximeter. It was at 92...... She passed away in 99. I came home with oxygen 24/7 in 2002 Dec 24th . I have learned alot over the years. Exercise is a must. I went from fev1 of 39 to fev1 of 21 this year. I also have severe PAH (pulmonary arterial hypertension) which also could be a cause of shortness of breadth too. I am severe copd and severe PAH along with hypothyroid. I could only walk 5 min on treadmill at the slowest speed because I desatureated way low. (67) Went from 5 min three times a day. to 2.5 miles and 3 miles an hour in one hour. I turn my oxygen up to 8 if I have to in order to stay in the 90's on my saturation level. I also do PLB. Pursed lip breathing and that helps to not to get short of breadth. If your really short of breath, when you walk, take a deep breadth and walk when you slowly breath out. Stop inhale a cople of times and the repeat walking and slowly pucker lips as blowing a whistle . Breath in one two three four and blow out slowly one two three four five six etc until you exhaled is completted. Some people breath in 3 and blow out six. What ever feels good to you is ok.....This will help your muscles use oxygen efficiently. If you are walking with o2 on and getting short of breatdh, then you should talk to your doc about turning your o2 up while doing this. I used to live in high altitude Colo and they had me on 2L oxygen sitting and 4-6 walking. I am now in a lower lever Nebraska and I sometimes sit without it on and just do PLB but I usually have it on demand 3 or 1L continous..... Works for me...
When I first started working out, exercise 5 min three times a day would make me feel extreemly tired the next day. So I would do it every other day and pretty soon every day and each week increase. I got to go to the park and walk 1 mile with my husband and enjly the fresh air and sunshine.(10 min day of sunshine good for depression) The highest I got walking was 6 miles at one time. But usually its a mile now is what I do and I now doing the Leslie sansone Walk at home cd I got from Sams club. I do it at my own pace and it only takes half hour for 2 miles ..... I am slower than her and stick to what is comfortable for me. I get the sludge out of my brain and get the blood moving so it also helps depression and weight and your muscles and it helps get rid of Edems if you get up and move.
I am trying to answer alot and just hand out what has helped me. One more thing, if your on chlosterol meds, have your calcium levels checked, the meds affect your coQ10 levels and your calcium levels. So have those levels checked to see if your ok on calcium and coq10. Coq 10 helps with heart arithamas.
I had an allergy test and only thing Is ragweed. I had vitamin levels checked and all my levels are above the averge listed except my serine levels which was low. So I am taking extra protein drink with the serine as one of the ingredients. I do this in the morning and it has helped me maintain weight (197) and I lose 5 lbs a month. I was up to 210 there for awhile. The extra protein helps keep me feeling full and also gives me the needed protein needed with this disease of copd. One more thing, if you want to help shortness of breadth, stop junk foods with sugar, like doughnuts, alchol, pies, cakes etc. They cause shortness of breadth from the sugar and carbs. Use stevia or some other like honey is ok....we can share what works for you and me and just swap what we have learned. The meds I take is synthyroid for thyroid, foradil and qvar are my inhalers. I take tracleer 125mg for the pulmonary hypertension. aldactone 50 mg twice a day,amlodipine 10 mg (congested heart failure Edema) prednisone 10 mg every day now. (pred and synthroid also cause edema.) I am keeping the edema off the legs and ankles. 9 years with this illness and this is the first year I have slowed down and feeling slower. I been traveling for three years in Rv enjoying every bit of what I have left of my life... Let no one tell you how much time you have left. Its all about attitude and goals. Serine I mentioned I was low in is helpful for depression. I have ben depressed and the snythroid affects the serine levels I hourd out. So will get back with you on how I am doing after being on this protein and dhist alterate vitamin I am taking to.(supposed to help IgE levels too. got mine down from 1000 to 200 now.If the Dhist doesnt work in 6 weeks, then I will get the shots for the ige. High Ige's is inflammation markers. Not good..... allergies is what it means and all i am is ragweed and what med?? I have goten off diff meds and now on these. I think I have done great for 9 years and two hospital visits in the first two years. No other problems except reaction to leviquinn, it caused sever muscle wasting for 6 months. I only used it once, did not agree with me, but I know others who love it. thats all Gloria

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I like all of you before me, I Have no set answer to give. I lost my husband two years ago come Aug. And I guess this is more a Thank-you to all of you for sharing all you are going thru or have gone thru. For this is the first time I have even allowed myself to reflect on all he and I had to endure, In and out of the hospital for the first year. Then he went in for a cold and stayed. A year hooked to machines to feed him to help him breath. Doctors said he would never get off them,he had surgery Doctors gave him a 5% chance. What his Doctor said to me was you know we are going to lose him today. He made it. Tubes in his thorax,stomach,and arms, In a hospital care unit he stayed a year. They said he would never be able to go home . I would leave work and drive 30 miles to see him every night,and he would cry and beg me to take him home, I would tell him soon, soon. Somehow he would make clicking sounds and I was able to know what he wanted to say, or needed.
One day when he looked at me so sad,I said to him " THE ONLY WAY YOUR GOING TO GO HOME IS IF YOU GET OFF THAT DAMM THING AND BREATH ON YOUR OWN" 72 Hours later he was!very weak but off the ventalator. He could not walk or talk but he was home just waiting...... He learn to walk and talk again he also drove our car a few times. So many times he would tell me he didn't want to go on anymore for everyday he was in pain, and I tell him I didn't want him to leave me, The last week he said to me Honey I don't think I can do this any more but I'll try.
4 years he stayed for me. So for the ones that want to know how long till your love one is gone. There is no time frame to follow ,But given a reason and a will to live, His doctors said is what kept him alive so long after all medical reasoning was gone. Again thank you maybe now I can grieve and start my life again.

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Just want to clarify something about meds given to people with COPD: Ativan (lorazepam) is an anti-anxiety drug and is taken by people with all kinds of diseases or people whose only affliction is anxiety. The reason so many people on hospice get this is because many of them have a lot of pain and/or trouble breathing, both of which can cause the body to go into "fight or flight mode" where extra epinephrine (adrenaline) is secreted by the adrenal glands and messages are sent to the brain to breathe faster. This works when we are in danger and can breathe properly but when lungs aren't working well and a person can't take deep breaths or their lungs can't absorb the oxygen from the air they breathe, anxiety kicks in. For a lot of people, lorazepam eases the anxiety and allows the person to slow down their breathing to a pace their bodies can tolerate. Oxygen helps, too. Morphine is given to ease pain and for respiratory distress. It helps ease the work of breathing. slows things down a little when a person is working too hard to breathe.

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my grandfather has copd he is getting a lot of gas and his fingers are getting numb could anyone let me know if its normal ??? we do not know what stage he is in he gets a pain on his chest all the time he doesnt like to sleep at night he sweats a lot he eats just a lil can someone help me and tell me whats going on.. his tounge is swollen its ylw and wht .... is anyone going threw this

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hi all,i have been disabled with osteo arthritis,fibromyagia,cfs,asthma since chiid hood,i was diagnosed with copd in2008,i went to my doctors im in the uk by the way 3 week ago,she was appalled i hadnt been seen since my diagnosiis i am in stage 4 of copd i am 49 years of age,i had a 5 year plan now i have been told that i am not expected to make 2 more years,how do i tell my children?? i am angry that i thought i was being treated for chest infections for my asthma,i had a pulmary embolism 10 years ago,that nearly killed me,i just do not know where to turn,my chidren know of my copd they just dont know the extent,i try and live life the best i can i dont show on the outside but i am scrared frightenned,and lonely,i dont know where to go or what to do,my every breath i think is my last,i went to my doctors and i actually told her her i feel i have the death rattle ,please how do i helpmyself to help my chidren and grandchildren ive run out of energy wendy x

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to ahmed 1988: It sounds like your Grandpa has "thrush". It is a fungal infection in the mouth that can be painful and needs to be treated with an antifungal wash. Your doctor or hospice can provide this. This can be a side effect of the morphine. The morphine also can cause constipation, which will lead to discomfort and possibly gas. He needs to take Miralax for that. It is available over the counter. My mom has not had the numbness in the hands, but the chest pain and sweating could mean he is having a heart issue. Please call his doctor and try to get a professional opinion on this as his symptoms sound very serious. There is help out there that will be covered by medicare and/or hospice if you don't have the money.

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In answer to 'allmymarbles' question above, as to whether 'the stages are measured with or without medication', the answer is 'with'. I have very severe COPD, use 02 etc. and asked my specialist this question. He said that your post med fev1 (which determines which 'stage' you are at) is the one to use. Hope this has answered your question.

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My mother has had COPD for over 10 years. She is not on oxygen but I think she needs it sometimes. She still smokes. She ardly eats, and cannot walk more than a few feet without getting SOB. I just took her to the doctor last Wednesday due to severe fatigue and general malaise and she sent us right to the ER. They said she has pnemonia. I went back and forth everyday for 6 days, cleaned her apartment, did all of her laundry, bought her a ton of food, and when I brought her home, the first thing she did was light up. I feel bad for her, but enough already. How much sympathy can you have for that? Last year she was in rehab due to a broken hip, for three months. She could not smoke then and was walking 100 feet with no problem. The physical part of her addiction was well out of her system by then, and within 5 minutes of being home after that, she lit up. She gets angry and ornery when I try to talk to her and says she's trying. I do not call that trying. I have two kids and live 45 minutes away, so if she was trying so hard I might have a little more sympathy.

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Life expectancies for otherwise healthy 65-year-old Caucasian males,
Current smokers with stage 1 COPD have a life expectancy of 14.0 years, or 0.3 years lower. Smokers with stage 2 COPD have a life expectancy of 12.1 years, or 2.2 years lower. Those with stage 3 or 4 COPD have a life expectancy of 8.5 years, or 5.8 years lower.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2672796/

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Hi all, I lost my mum last night to copd, she was hospitalised on the 1st December 2012 and came home after a week but the pain she went through must of been horrible, we loved and supported her and but unfortunately she was taken into hospital on the 5thapril 2013 after vomiting black and brown mucus I knew that this was then end and on the 7th April 2013 she left us, we said our good byes but her final 6 hours was awful as she lied there not able to eat talk or hardly breathe, good night mam I love you RIP, remember one thing be there and love them and making them happy.

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My mum has passed away with copd, I knew that she had this disease but oh how I wished I had looked into the final stages...I visited her at home most days, but towards the end she stopped any conversation unless prompted, the confusion was awful, mobility a no go,so became incontinent and had to wear pads, was admitted to hospital and was told there was nothing more other than keep her comfortable that they could do. She passed away a few days later, no talking, eyes closed, but could nod head so at least she heard our goodbyes ... I am now fully aware of some symptoms now, and will discuss these with the Dr as we have another family member with this dreaded disease.

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I have had COPD for almost 11 years. I gave up smoking only two years ago. I was taking only two meds. Spiriva and Advair for the last 5 years. I got to the point where I was exhausted 24/7 and both feet ached like crazy most of the time. In my search for something that would help to kill this disease before it could kill me I discovered something that does actually work to reverse emphysema. Please visit this Facebook page and ask about a book called , "How I Reversed My Mom's emphysema". Here is the address https://www.facebook.com/groups/COPDTreatments/?fref=ts
I am taking his advice, following it to the letter and for the first time in several years I am actually starting to feel better. My doctor insists that I continue with my meds but as with most doctors...their real job is to sell pharma drugs and they are perfectly alright with you and I going to our grave so long as we remain on the meds right up to the end. I plan to be clear and free of this dreadful problem before the end of this year and you can do the very same thing. Check it out and see what you think. You have a lot to gain from investigating this one!

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I am a hospice nurse, Case Manager-RN. I have cared for many patients with end stage COPD. It's a very debilitating disease and extremely hard for caregivers/families to understand. In the last stage, when the Pulmonologists have nothing left to offer but comfort, embrace it. Those who fight against palliative or otherwise known as comfort care, are not extending the quantity of their life but rather worsening their quality of life. There is a happy medium. With the right hospice staff (earlier in the last stage) can provide both. Contrary to the stigma attached to hospice; we truly do everything possible to provide excellent care in the home setting. This allows the patient and family to make their own informed decisions based on good information provided by professionals. The hospice team can streamline medications deleting some which are useful in the early stages, however cause more harm than good in the end. Advair and Spiriva are valuable in the beginning for symptom control but ineffective if the patient is unable to inhale and hold breath for ten seconds. Ativan is frequently used for two reasons 1) shortness of breath and 2) anxiety. It doesn't matter which comes first: anxiety that causes SOB or SOB that causes anxiety. They are both treated with the same medication, Ativan. Slows down respiration rates resulting in quality breaths not quantity of breaths (hyperventilation). Morphine, also known in a concentrated liquid form called Roxanol, also very effective. A vasodialator, assisting the cardiovascular system to perfuse (push) oxygenated blood throughout the body with less resistance. Actually the side effect to an opiate such as Morphine is depression of the respiratory system. This also assists in providing quality breaths vs quantity of breaths in addition to chest pain associated with COPD. Other options hospice can offer are nebulized morhine and Lasix as needed to minimize the debilitating symptoms that are common to the disease process. Nurses available to act as a liaison between physician and patient; preventing agonizing doctors visits and the lengthy wait for a call back from the doctors nurse. Durable medical equipment delivered for the patients convenience as the disease process progresses unexpectedly. No more Emergency center or EMS if the patients symptoms can be controlled at home. But more valuable than any of the above is the education provided and specifically designed for each individual unique patient. All COPDers do not present the same. Patients agree their quality of life is better when their case is managed day by day and symptoms are managed. I am able to answer questions for my patients they have never thought to ask like why breathing is easier when bending over a table or chair. Answer: because this anatomically opens up the lung bases where gas is exchanged, allowing more surface space to let bad gas out making room for good gas (oxygen) to enter. Emotional support is important as well as validating feelings of anticipatory grief. Although hospice isn't everyone's answer to coping with COPD IV it could benefit patient and family. Each one of my COPD patients hold a very special place in my heart and I'm forever indebted to them for increasing my knowledge in effectively caring for the individual and not the diagnosis. Hope someone reading will reach out to their physician and ask for a hospice referral for evaluation. Not because they are ready to give in to the disease but rather ready to fight symptoms with alternative treatments in the home setting provided by a team of professionals who are experienced with COPD and its ever changing complications.

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Hi
my mom is 80. she was diagnosed with COPD 3 years ago after smoking for years, she quit smoking right away and has to be on oxygen all of the time, we went in and they told her that she has 40% lung capacity and because she has to be on oxygen 24/7 she has stage 4 Copd.

she also has diabetes and high blood pressure. she keeps telling me its the end, well I have been hearing this fr 3 years so I cannot take her seriously, is she right? is it the end? I mean does anyone know the life expectancy in general for this situation?

she has to use a machine 2-3 times a day as well as the oxygen to breathe better (forgot what the machine is called) and then of course her inhalers, she loses her breath and gets very tired after just a few moments but like I said, she has been saying its the end for 3 years, lol

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I have an FEV1 of 62%. It's been as low as 51%, so I'm skirting the edges of Severe COPD. I'm lucky. I don't have to work much, so I spend A LOT of time at the gym. I try to do 1/2 hour on the elliptical and then 1/2 hour on the recumbent bicycle. I also do as much upper body weightlifting as I can. I do that to build muscle because I know that when I get to the next stage and I can't do the exercises any more my muscles will start to waste away. Don't believe them when you say that old guys can't build muscle. I'm 59 and I've seen a difference in my shoulders and back and arms. I'm going to get as big as I can by adding muscle, not fat, before it starts to go back the other way.

I get the headaches. I take so much ibuprofin that I bruise super easy. I take all my meds every day and do a sinus rinse every day. I'm working the program my specialist has set out for me and I'm a lot better than when I was diagnosed 6 years ago. At the time I was about 300 lbs and just thought I was out of breath a lot because I was so big. So I was undiagnosed for a long time and in pretty bad shape back then. But the meds and the exercise, especially the exercise, have helped a lot.

Stay on your meds, stay as active as possible. Join a gym. Check with your local hospitals to see if they have rehabilitation centers that will function like a gym. I go to the Tom Landry Center at Baylor Hospital here in Dallas. It's a regular gym but they also do rehab for the hospital, so I don't feel so conspicuous because I'm surrounded by people like me; ill and trying to deal with it. It's lots more comfortable than going to the local Meat Market style gym.

Good luck to everybody. And keep up the good fight.

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I was diagnosed with lung cancer in Sept. 2013 - stage 1A praise God, after quitting smoking 18 years ago; I was 69 at that time. I had a complete lobectomy of my lower right lobe and have completely recovered from that, have been getting CT scans every 6 months since; all clear of cancer. I have, however, now been diagnosed with Emphysema - no mention of what phase, but I expect a low # because I remain active, walking 2+ miles daily, while also using prescribed meds - Spiriva, Asthmanex. I'm writing not because I need help, but because I want to encourage anyone who is ready for "palliative" care to reach out to Hospice in your area. I've lost my Mom (at 95), my husband (at 60) and my younger brother (at 66), each to one cancer or another and, in each case, the Hospice Caregivers were our absolute Angels. There is no more loving or caring group of people on the planet, in my opinion. I don't know when my time will come, but I know that I will be blessed if I, and my family, can have this precious care at that time - they take care to support not only the patient, but also the caregivers, leaving no one out "in the cold" if they can possibly assist. And, it should be noted, people do not always get worse under their care - people also get better and exit their care in better health and with no end in sight. Thank God for Hospice workers everywhere! Angels on Earth.

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Hi JoMamma, I too was told nothing about stages and that I was borderline copd or emphysema summer of 2010 and to quit smoking. Well I havent had ins. Since oct. 06 until now so no real testing has been done but my dr. Is awesome and has been giving me symbicort regularily from her sample closet, I didnt need it everyday until a couple years ago and i always use twice a day and have needed prednisone on two or three different occasions. Well my brother of 48 years was killed just over a year ago and my mother being do distraught said that's it I am not burying anymore children, so about 1mo. And 10 days after his funeral I guit smoking after 33 years at the age of 50. Well I think it was just before that, that my doctor started saying I HAD copd, not borderline. I thought it would'nt get worse if I quit, but as I said, I haven't even had an xray, but today after struggling to bresthe for about a week after getting a cold I decided to get online, and I end up here, so now I am really scared. Like I said I did'nt know there were stages, but I just got ins. And I live in Denver so I am calling my Doctor tommorow and getting a referral to National Jewish.

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I was diagnosed few years ago I'm on O2 for 3yrs.Otherwise I can still make do .It takes a long time to do things, I used to do in a FLASH. It's frustrating & maddening, especially when I look around & want to do more because it's all starting to pile up .I'm 45 miles from the nearest town . Never been one to ask for help but I'm learning. REALIZING LIKE IT OR NOT I NEED THE HELP! If you know someone with copd , shovel the driveway , mow the yard , make sure sattlite dish is clear , start the car once in a while, get groceries, most of all don't rush me I'm going as fast as I can right now, we'll be faster tomorrow maybe. Please use patience. It's kinda scary sometimes from this side ,and sometimes I'm not clear because I'm not here with you .I'm in a space where I'm not in tune with my surroundings and not able to focus on the NOW.As for watching TV all the time ,I'm focusing on that instead of beating myself down with recriminations.

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My dad had chemotherapy, it erased all his Immune system library that recognized allergens.He would have type 2 allergic reactions to every speck of dust. This is a fluid retention reaction. It acts like COPD. I figured this out and bought a bunch of box fans, then I put $20 allergen furnace filters on the suction side of the box fans. I then wiped down the television screen left the fans run 24 hours, if the screen was dusty wipe it and add another running box fan filter 24 hours check again. The idea is to filter the dust out as fast as it comes in, the television screen is an easy way to monitor this. If it was a boat full of water it would sink if you pumped to slow and make noise if you pumped to fast. Operating rooms only get down to 1 speck of dust per quart, it is coming off the patient, the staff the cloth used in the clothes and sheets etc. Make sure you are not having something else, you can help, to accelerate the copd you do have.

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My 76 year old mother is home on hospice care for COPD. She actually seems to be improving slowly and rarely needs to be on oxygen. She was having difficulty with nausea and anxiety, two symptoms that many seriously ill people suffer from. A friend suggested ABHR gel (pharmacy compound of lorazepam, benedryl, haloperidol and reglan.) It is relatively inexpensive and so easy to give, just rub on inside of arm. It helps nausea, anxiety and she has even reduced her pain meds since using it. Added benefits are increased appetite and comfort, due to control of nausea. It's worth discussing with your medical professional if these symptoms have been a problem. Hugs to all.

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